CCN 345206 · Madison County, North Carolina
Madison Health and Rehabilitation
345 Manor Road, Mars Hill, NC 28754
Madison Health and Rehabilitation is a 100-bed for-profit nursing home in Mars Hill, North Carolina, first certified for Medicare or Medicaid in 1981. CMS rates it 5 out of 5 stars overall in its September 2026 data, and it averaged 84.6 residents a day, about 85% of its certified beds. It has an active FHA-insured Section 232 loan: $8.3 million originally, at 3.91%, with $7.3 million outstanding as of September 30, 2026 and maturity in October 2053.
Facility facts
- Certified beds
- 100
- Average residents per day
- 84.6 (84.6% of beds)
- Ownership type
- For profit - Limited Liability company
- Certification
- Medicare and Medicaid
- Legal business name
- Madison Health and Rehabilitation, LLC
- Certified since
- May 25, 1981
- Chain or affiliated group
- Sanstone Health & Rehabilitation (18 facilities, chain average 4.3 stars)
- Location
- Urban
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | North Carolina median | US median |
|---|---|---|---|
| Overall rating | 5 of 5 | State spread: 91 at 1, 83 at 2, 85 at 3, 75 at 4, 81 at 5 | |
| Health inspections | 4 of 5 | ||
| Quality measures | 5 of 5 | ||
| Staffing | 4 of 5 | ||
| Total nurse hours per resident per day | 3.60 | 3.53 | 3.68 |
| RN hours per resident per day | 0.67 | 0.51 | 0.58 |
| Weekend nurse hours per resident per day | 3.02 | ||
| Nursing staff turnover | 37.9% | 48.6% | 44.9% |
| Occupancy (residents / beds) | 84.6% | 87.4% | 85.7% |
| Fines reported by CMS | 1 totaling $9,110 | ||
| Health deficiencies, latest standard survey | 1 (Feb 11, 2026) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Madison Health and Rehabilitation meets that part today: 5 stars overall, 4 on health inspections, no abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| Sprenger, ChristopherIndividual | Direct Ownership Interest | n/a | 12/14/2010 |
| Madison Healthcare Properties, LLCOrganization | Mortgage Interest | n/a | 10/22/2013 |
| Ardent Health and Rehabilitation CoOrganization | Operational / Managerial Control | n/a | 12/14/2010 |
Holders of a 5% or greater mortgage interest reported in the enrollment record: Madison Healthcare Properties, LLC.
Changes of ownership
No change of ownership for this facility appears in the CMS change-of-ownership file, which starts in January 2016.
HUD Section 232 loans
HUD's Office of Healthcare Programs lists these FHA-insured loans for a project we matched to this facility by name, city and bed count. Status, rate and balance come from HUD's insured-mortgage files as of September 30, 2026. Check the FHA number against the loan documents before relying on the match.
| Endorsed | Program | Original amount | Status | FHA number |
|---|---|---|---|---|
| Sep 26, 2018 | 223(f) refinance or purchaseHUD project name: Madison Health and Rehabilitation, 98 beds. Lender at endorsement: Lancaster Pollard Mtge Co | $8,320,000 | Active: 3.91%, $7,304,049 balanceMatures Oct 1, 2053. Servicer: Lument Real Estate Capital | 05322224 |
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.